We had received reports of dengue infection in military and civilian relief workers returning to the US in February. At that point, it was an issue easily handled at the physician-patient level. Speculation suggests the timing of this particular advisory may reflect a concern not only of seeing more cases in returning relief workers but seasonal mosquito emergence in the US- particularly Aedes aegypti and Aedes albopictus.
The salient concern here is whether returning dengue-viremic relief workers, if bitten by US-endemic mosquitoes, could trigger localized outbreaks. Key West, Florida just experienced this problem this past fall, so there is some sensitivity to this issue. This will be an increasing concern as ambient air temperatures optimize in July for most of the US (and people spend more time outdoors exposed to mosquito bites). The southern states will be expected to reach temperature optimization sooner in the season.
Given reports of increased malaria activity, there is a broader range of potential infectious diseases to consider as well when seeing ill patients returning from Haiti.
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